The Consultation | by Linda Sherby, Ph.D, ABPP

08/21/2017 10:37 PM | Anonymous

In this weeks blog, "The Consultation," a patient presents herself as an angry, contemptuous woman, hiding the sad, damaged child underneath.

Rebecca Whitman rises from the waiting room chair extending her hand to greet me. She is dressed in a pale lavender suit and matching high heeled shoes which are surprisingly flattering with her flowing dyed red hair. I wonder at her age. Mid-forties? Hard to know how much plastic surgery she’s had.

“This is a consultation, right?” she begins immediately . “I’ve had lots of them. You get to decide if you want to work with me and – never to be forgotten - I get to decide if I want to work with you. So what do you want to know?”

Feeling as though she has just thrown out her opening salvo, I say, “That’s quite a beginning.”

She sighs. “I believe in getting to the point. Why waste time. It is my money after all.”

“Do you want to be here, Ms. Whitman?” I ask, noticing that I have automatically called her by her last name.

“Why do you ask?”

“Well, we’ve never met before and yet it feels to me that you’re already angry with me. That doesn’t make much sense unless you’re angry at being here.”

“I’m always angry. I’m angry at being here. I’m angry that I have to pay you to listen to me. I’m angry that I’ve seen I don’t know how many therapists. I’m angry they’ve either thrown me out or been completely incompetent or both. I’m angry that even though I’m one of the best real estate agents in the area, I eventually get shown the door. No biggie, I’m good enough I always find another agency. I’m angry that I’ve had three failed marriages and heaven knows how many other relationships that failed. Any questions?”

I feel torn. A part of me wants to join all the others who have gone before me and stop this consultation immediately.  But another part, perhaps the grandiose part, wants to give it a shot. I do know if I’m going to try, I want to do something other than taking her anger on directly. 

“What would you be feeling if you weren’t feeling all that anger?” I ask.

She laughs. “I’ve heard that one many times before. You think a simple question is going to have me dissolve into tears. You’re going to have to do better than that.”

So much for not taking her anger on directly. “Do you like being angry? Do you like losing jobs and relationships and therapists? And why are you here? What do you want to accomplish?”

“Better,” she says.

I feel myself getting angry at her constant evaluation of me. I keep silent.  

The silence persists.

“I guess you want me to answer your questions.” Pause. “Ok, Ok, I’ll answer the questions. Sometimes I like being angry and sometimes I don’t. And, no, of course I don’t like losing job or relationships.” Pause. “I’m not sure why I’m here. I guess I’m hoping someone doesn’t throw me out.”

Her last statement sounds so sad that I find myself fighting back tears. 

“Someone I can have respect for, that is,” she adds with her typical bravado. 

My sadness shuts down immediately. Rebecca Whitman has told me a lot about her defensive need for anger.

“If I ask you who was the most significant person in your life who threw you out, who would you say?”

She shrugs, “My mother.”

“Ok, Rebecca, so I do think you’re afraid if you let down your anger you’d be left with lots and lots of tears, tears of loss, abandonment, worthlessness and, of course, rage.”

“Think you’re smart, huh?”

“Rebecca this isn’t a contest. I’m not here to beat you in a competition. I’m on your side. And I know you can’t simply put away your defensive angry. It’s been a part of you for a long time. But hopefully if you come to trust me, you can let it down little by little and together we can deal with the pain underneath.”

“Ok smarty-pants, guess why my mother threw me out.”

“There’s no way I could guess that, but I’d appreciate your telling me.”

“Because I told her my step-father – step-father number three, by the way – was doing it to me.”

“Oh, Rebecca, I’m so sorry.”

“Yeah? Yeah? What the fuck good is your pity going to do for me? I was eleven years old. Eleven years old for God’s sake!”

“That’s more than reason enough to be angry. But you must also feel sorry for you as that eleven year old child.” 

“I don’t believe in a pity party!”

“Compassion for a child is not a pity party.”

“So are you going to work with me?”

“Yes, Rebecca, I’m going to work with you. I’m not going to throw you out.”

“Ok,” Rebecca says as she sprints towards the door.

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